How can I cure erectile dysfunction?

Question

Hello doctor,

I have erectile dysfunction with no apparent cause. The blood test and ECG are fine. I have never had ED. My sex drive is usually not even too much. For the past eight months, my sex drive has been non-existent. I also have no morning erections. Factors that play a role are that I broke up with my wife. Also, eight months ago, I had a severe accessory nerve operation that failed to fix my trapezius palsy, but I think these areas are physically too far apart. But maybe depression? I have not been able to believe myself to be turned on. I have tried Zinc, Magnesium ZMA vitamin supplements which seemed to help for one week, and I got hard morning erections. However, it stopped working. I have also tried Ginseng, which does work, as well as Tadalafil prescription works too. I can stimulate the penis with no medication and ejaculate, but I usually have to look at porn (which I do not often do because I have no libido whatsoever). I have failed to have sex with three girls because of a lack of desire. I want to get it up physically, but it does not get up. I have ED, and I cannot get it up to beautiful women, which is horrible.

I have slight pain in both testicles, which is, I think, because I have not masturbated. Feels like blue balls, which are there when a man gets turned on but does not cum, so it hurts a little. No lumps are there on or in the testicles or anywhere else. No STDs, of which I am sure because I had only five partners, of which my ex-wife now was for the last four years. All were protected sex. All tests came back normal. Only ECG said signs of hypertrophy but compared to ECG three years ago, not any significant change, so I doubt this is a reason. Also, note that the testosterone levels are acceptable. I usually get eight hours of sleep, but this may be because of sleep apnea. I never feel too rested.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern. Relax and do not worry. ED (erectile dysfunction) can be because of mainly two causes: Psychological (lack of desire leads). Psychological ED can have many reasons, like stress, strain, anxiety, mental trauma, etc. Vascular (lack of blood supply in the penis due to narrowing of vessels). We need to differentiate between the two as treatments for both are different. Your reports are acceptable (attachment removed to protect patient identity). They do not suggest any hormonal problems. I would like to have one more test, which is penile doppler with vasoactive substance injection (Papaverine). This will test whether the blood flow in your penis is adequate. I feel you have a psychological cause because of your relationship with your wife and other stressful events. Moreover, it has formed a loop as now you are in fear that every time it will not erect. So, I feel it is a psychological cause.